REGISTRATION FORM

2012 KANSAS ASSOCIATION OF TAXIDERMISTS CONVENTION AND COMPETITION

30th Annual Competition and Convention
Courtyard by Marriott Convention Center
Junction City, KS  66441
MARCH 23-25, 2012

The registration fee includes one adult banquet ticket and all snacks.  All registrants must be a member of their respective state association AND SHOW PROOF OF MEMBERSHIP from other state association or pay the non-member fee of $135.00.  We will not recognize NTA memberships.

Name______________________Address_______________________________

Spouse’s Name__________________City/State/Zip_______________________________

Business Name______________________________Phone(____)____________

Email & Website Address:___________________________________________________

Registration Fee $100.00 – K.A.T. members / $135.00 non-members                                                                                    $_______________

K.A.T. Membership dues $25.00                                               $_______________

Additional adult banquet tickets
(13 yrs and up______X$20.00/ticket)                                        $______________

Children’s banquet tickets
(5-12yrs old)_________x$10.00/ticket                                       $______________

Banquet tickets age 4 and under needed________________________FREE______________

Competition pieces_________x$12.00/Entry                            $_____________

Electric Outlets_________x$10.00/plug in                                 $______________

Competitors Award
(4 entries of any category) $10.00 entry fee                               $______________

________________;_________________;__________________;_____________

All Around (4 entries in different categories, see rules) $10.00 entry fee

________________;__________________;__________________;____________

Combined Artist
(judged at highest entry taxidermist level) $10.00 entry fee         $_____________

______________________________________________


                                                                          Total Due            $_____________                                         

                                                                       Total Enclosed     $______________

                                                         Balance (if necessary)        $_____________

CATEGORY              SPECIMEN     Amateur/Professional/Master/Commercial

_______________     _________________        ________________

_______________     _________________        ________________

_______________     _________________        ________________

_______________     _________________        ________________

Make checks payable to K.A.T. and return by March 6^th, 2012

To:          Sean Bechtold
                308 E. A ST.

                Hillsboro, KS  67063                

                

PLEASE SIGN AND DATE RULES ON RULES PAGE